Book reviews

Feeling safe does not seem to go hand in hand with liberty. An important balancing exercise ensues when steps are taken by the state to respond to a perceived threat to national security and, at the same time, ensure that in acting in the interests of society to answer these threats, basic civil liberties are not undermined. Concerning this delicate and fraught process, Gross and Ni Aoláin aptly observe:

Since that time he seems to have directed his whole attention to the subject, and now offers the result of his labours under ttoe powerful recommendation, we might say under the sanetion, for the truth of all he states, of no less a name than the late much-lamented character, whose industry and accuracy evinced itself in whatever he undertook. <c On the 15th of September last, (says Mr. Whitbread, in a Letter addressed to the Governors of the Middlesex Hospital) I met Mr. Young, at the house of Dr. Penrose, at Hatfiehl; and, having received from the latter the most positive assurance, at the plan could not produce any mischief, and afforded a prospect of relief, the experiment was decided upon; and on the next day it commenced, at the residence of the patient, within a short distance of the town of Bedford, in the presence of Dr. Penrose and myself. On the same day, Anne Wildman, whose case is amongst the most remarkable of those detailed by Mr. Young, was brought from the Bedford House of Industry, and .after minute examination bf Dr. Penrose, Subjected to the. same process* . .

? F>om
Mr. S. Young on Cancer and Cancerous Tendency, 411 ? From that period, Mr. Young has resided in Bedford and its neighbourhood; and several patients afflicted with cancer, or dfo-i -eases of that tendency, have been placed under his care. ^The minutes of the cases are drawn up by Mr. Young; and the attestations and opinions of the medical men, and others who had known the origin, or seen the progress of any particular case, or had been called in to decide upon the eifect of the treatment, are given in their own words. " The very remarkable case wherein the practice was so promptly adopted by Mr. Macgrath, of Biggleswade, from having seen its application under the hands of Mr. Young, is described by Mr. Macgrath; the value of whose testimony is known to an extensive circle.
I thought it might be of some service to the cause of humanity, to see with my own eyes some of the cases; and 1 have been more than repaid by witnessing the progressive amendment of the patients, and by hearing from time to time their -joyful declarations, that they were greatly relieved from the torment of their previous psun.
i( Where Mr. Young has introduced my name, he has faithfully described, my impressions." Mr. Young commences with a general account of his pJaij of operations. u Pursuing (says he,) the same train of facts, an account of which was published in 1805, under the title of 6 An Inquiry info the Nature and Action of Cancer, in order to establish a Principle of Cure by Natural Separation,* where it was proved, that the disease can only exist under a previously altered and morbid accu^ mutation of structure; but, considering the necessarily confined ap?* plication of such a principle of cure, in a disease so complicated, so variously acting, so indefinite in extent, and so often involving parts necessary to life itself; the idea of a more extended effort for the removal of the disease by mechanical pressure suggested itself; and so far back as the year 1809, in two cases, it was successfully employed. 4< The principle of this practice was found in the obvious facts, which nature is constantly presenting in the operations of the ani. mat oeconomy, viz. the removal of parts by absorption, and parti, cularly under -the excitement of pressure. It is true', such facte; were presented through the medium of disease, but the principle was the same, and only required another direction to obtain beneficial and healthy results.
If by diseased tumours the brain can be absorbed, the bone$ of the skull removed, or the testis in hernia congenita obliterated, to reverse the powers of absorption seemed feasible. If, by diseased pressure, healthy structure could thus be removed, why not imitate such pressure, and take advantage of such powers, by directing them to beneficial purposes, and destroy in turn morbidly formed parts or tumours, by the very means with which Nature has fur. pished them, for the destruction of natural structure ? 412 y Critical Analysis. ** By such morbid pressure arterial action also is suppressed* Why then should a tumour of the neck, for example, be suffered to proceed in all the licentiousness of disease, destroying on the one band by its pressure the natural circulation of parts, and on the other exciting the absorption of natural by unnatural structure; ?when the same pressure, employed on its own surface, would obstruct its growth, and cause its own absorption ? Under this impression, and on the principle that mechanical pressure resists vascular action, and excites the absorbents, it was adopted as a mode of cure for the removal of cancer, and other diseases dependent on previously altered and morbidly accumulating structure. One inight enter largely on the more minute operations of this process, in the prevention and restoration of diseased structure; but the present object is simply to give a brief statement of leading facts. There are, however, many curious and important truths, connected with and illustrative of the nature and history of diseases of thi? class, the detail of which shall be given at some future opportunity.
The means generally employed to effect the pressure as stated in the following cases, have been plaster-straps, sheet lead forming shields of various thicknesses, tin plates, linen compresses, and the use of appropriate rollers. ff The strength of the application of the pressure has been pro-? gressive, commencing in most cases with the use of the 6traps only; in some by single, and in other cases by double layers. The force of their application controlled in each instance by the existing pir-? cumstanccs, and the sensations of the patient. The plaster should be uniformly smooth; and in the application of the straps it is of the first importance that all wrinkles should be avoided; th^t au equal surface of resistance should be given. In the direction of specific pressure on a diseased part, all sort of partial stricture must be avoided, according to the common principles of surgery, which may be illustrated by the now common treatment of an ulcerated leg, after the admirable pjan of Baynton. Here the ulcer of the leg is specifically compressed, although general pressure is also given to the limb, by the use of the roller. So a scirrhus of the breast may be specifically compressed, by the use of the pressure plates, and the adjustment of the linen compress, including at the same time a general pressure of the whole." The rest of the work consists of cases minutely detailed and amply authenticated. As we cannot be expected to offer any opinion on a subject so new, all that will be required of us in the present state of the inquiry is to furnish sufficient evidence, that Mr. Young is entitled to a candid hearing. We have selected two cases, not as more pointed than the rest, but because the disease was seated in differently constructed parts and in different' sexes, and because the interest of both much encreased by the relation of the patients themselves. Jitimseif.']?-' First came a small sore, and called a wart. Tried' means to kill it: but all to no purpose. It has been coming to what it now is for this four years. The symptoms are, continual, pain, otherwise shooting. Grew to a scurf, and then came off; and when off, underneath was a seedy root like to a cauliflower, and then grew again in a little time.' il This statement, though not explicitly entering into detail, suf. ficiently shews the active nature of the disease, and the progressive morbid change, that has been going on in the structure of the lip. For the increase of the tumour, it is to be noted, has been from the' enlargement of its base, and consequent involving the natural structure of the lip. " Upon questioning tho patient what he means by growing to a scurf, and then coming oft, it appears that the whole projecting surface of this cancerous mass, or wart, or excrescence, arising from an actively diseased and morbidly changed mass leading to cancer, has been in a state of ulceration for a length of time. That the different surfaces so exposed have shortly died, turning to a black,-smooth, and rather polished substance. That these partial disengagements have given a temporary strength of growth to the part, which has always ended in a succession of superficial slough.-The time between the operations of nature being from four to five weeks. " The incrustations, when thrown off, have been about two lines yi thickness, retaining the form of the excrescence they covered ; and the surfaces then exposed have had a hard sort of structure, like white cauliflower. These in turn, after a short growth, became of a dark colour, till they were changed to the uniform black incrustations described. So that, while the base of this tumour has been progressively increasing in intimate morbid connection with the structure of the lip, sloughing and separation, with partial' growth of its surface, have been going on in constant succession; strongly exemplifying the nature of such diseases, the strength they gain by mere partial destruction, and the consequent mischiefs of all partial removals. " During the four years progress of the disease, the patient consulted five professional gentlemen; but no remedy was found to check its advance. Caustics and leeches were applied to the lip, under the care of one surgeon, without avail; and Lea's health at length became so much affected from continual pain, as to require the adviceof an eminent physician : fresh applications were ordered to the lip, as well as general remedies; but still the local and constitutional symptoms continued in an aggravated state of advancement.
of the lip towards disease,?the whole of which is now little short of a complete scirrhus.
" From the margin of the black film, foul ulcers run inward into its substance, and a putrid effluvia is emitted, which is oifen. sive at some distance. This last symptom was particularly brought to my notice, by the man who accompanied the patient to Bedford. " The patient complains of a constant dry burning heat o# the skin, particularly affecting the right arm and hand, and mqre cs* pecially at his accustomed hour of rising, and about four o'clock in the afternoon. Other remedies were used, particularly the arsenical preparation of Dr. tie Valangin. We do not mention this tw lessen the value of Mr. Young's method by pressure, because it is well known that they have been frequently and ineffectually tried in cancer.
"March 14.?The lip quite healed, and restored to its natural state. A very active plan of pressure has been continued up to yesterday. The patient returns home, with directions of great caution to avoid the severe winds now prevalent, all excess in living, and to pursue the alterative and mineral solution plan, under the usual restrictions, for a week or two longer. "March ly.?Received a letter from the patient, wherein he mentions, that his lip is as smooth and level as ever it was in his life; that some little itching on the nose and lip remain; but that he supposes the medicine will stop it. Whitbread, in answer to a particular inquiry respecting the commencement of the disease, and the trmtm ment of it previous to Mr. Young's seeing it. " Hon. Sir, ** I received your kind letter, concerning my lip. Thank God, it is much the same as when I left Bedford, five weeks ago. Thank you for your goodness of recommending me to Mr. Young; and, please God, I hope it will remain well. The first of its coming, five years ago; it came a small scurf on my lip, and it was called at 1 wart. I applied means for a wart, but to no purpose, for a year or two. Then Dr. Chase, of Luton, took it in hand, and applied caustics and leeches to the lip for some time, to no purpose. He did not persevere in it now, as it was called a wart. He did not say what it was. Then we stopt. Then Mr. Somers had it in hand a considerable time, and no better. Then he had Doctor Penrose to see it. He give Dr. Somers advice how to treat with it, and give me medicines and applied something to the lip, and got no better. Then wish me to have Ashley Cooper's advice; but I did not go. Doctor Winkfield wished me to have it cut out; but I did not agree to it. Dr. Warren, Surgeon now to the Duke of York's Asylum, Chelsea, saw it two or three times. He wished me to have the best advice. He said it was a cancerous substance.
After all this, we heard of a woman at Westoning, Bedfordshire, that cured cancers. I applied to her, as it grew so painful and bigger, and she applied a burning caustic, which caused me a deal of pain, and got no better. She called it a dry cancer.
??-Then Mr. Whitbread and Sir John Sebright recommended me to Mr. Young, and he gave me a diligent attendance, and now, please God, it remains comfortable, and I hope will continue so.
Mr. Young deserves merits and thanks; likewise you, gentlemen.
ceive, to make it the duty of every surgeofl toattempt thfc same in these deplorable cases. v u Case 6f Mrs. Jennings, of Har ling ton, in Bedfordshire, aged 56; visited at Harlington, oh Tuesday, Dec. 6th; first medical attendance at Bedford, Dec. 16, 1814. ** Whether considered by the symptoms that attend it, the various parts affected, the extension of those parts, or the advanced and different stages of progress of the disease, this case present* one of the most extraordinary instances of complication that evcF existed, or can well be imagined. All the circumstances that have ever beeft enumerated as attendant on cancer, may here be seen at one view ; and are consolidated in this one individual case. manner, afFordin^the appearance of a claw firmly grasping the side. " On each side, from the breast to the axilla, the whole space is occupied by hard knobs, deep scirrhous puckeriiigs, and folds'in a most curiously confused state. On the left side it is inveterately marked. One fissure or fold is at least an inch in depth, and four or five inches in length, at the bottom of which a deeply imbedded scirrhous ridge of glands may be felt, leading to the back of the shoulder, where also there is a large mass of diseased glands. This fold is in a state of partial ulceration.
u~On the inner side, within two inches of the right fissure of the breast, there is a remarkable deep pea-like sore, which forms the cedtre of a scirrhous circle, about an inch in diameter, which is remarkably diseased, and of impenetrable hardness. This sore, it is supposed, was occasioned by the application of a leech. All the ulcerated and contiguous parts are discoloured; mostly of a livid purple hue, and of stony hardness. 4< The sores have been dressed with some simple ointment on linen, twice a-day; and large bleedings have frequently, indeed commonly, attended their removal. On the day I attended at Harliugton, upon the removal of a small part of the dressing, a sudden gush of blood followed ; which, Mr9. Jennings observed, was trifling, when compared with what tfften took place. The oharacter of the discharge is that of a thin fetid ichor.
ii In recapitulating this case, as it now presents itself, it may be observed, that the whole of the chest is cancerously diseased, including both breasts, extending down the integuments, almost to the abdomen, and comprehending on either side a large mass of surface, reaching from the breast to the axilla.
ii In the axillae, the glands are so deeply diseased, that their morbid extent is beyond the power of any examination to define; aud so complicated, as to defy every attempt at description.
The left breast is almost obliterated, and the nipple aud surrounding parts degenerated into a deep destructive sore; from this, reaching over the sternum, and including the other breast, is one sore and cancerous mass. Both arms are swelled, hard, and pain, ful. The neck almost fixed by diseased glands. The circumstance even of the bleeding cancer is not wanting to fill up the catalogue of those evils which the experience of centuries has selected as attendan t symptoms of the disease; selected, however, from a great variety of cases, and, fortunately for suffering humanity, but rarely, if ever, before found centred, at the same time, in one individual. But it is a great consolation to add, under the pressure of such a mass of foreboding evils,' that extreme or even violent pain has been hitherto unknown. The state of the arms has occasioned the greatest uneasiness. At this time, Dec. l6rti, considerable fever and general irritation exist; and, as this state was still more aggravated a few days back, it is not thought advisable at present to commence the plan of pressure* The following aK terative has beep ordered:  Harlington, Mr. Green, of Woburn, the medical gentleman attendant in the family, was present, who declared the case very pinch worse, and the sore greatly extended, since he had last seen it. He also represented to me that no regular attendance had been given, as the case had been considered quite out of the reach of relief. That for some time steel had been exhibited under the direction of Mr. Cooper, and continued till the fever it induced obliged its suspension. " In the hopeless state of the case I quite agreed; but strongly urged the adoption of a plan of pressure upon two grounds: first, ,for the suppression of the hasrnorrhage; and secondly, to suspend for awhile, if not permanently to check, the rapid progress of the disease, which was fast advancing to involve the whole surface of the chest, throat, and sides, in one wild and ravaging sore.
" When I gave this advice, it was under the impression that the plan would be pursued under the immediate regulation of Mr. Green; and that I was only called upon to give advice. It was, however, soon decided, that the patient should go to Bedford, and be placed under my management. Previous to the undertaking, I thought it right distinctly to state my opinion of the case to a lady then present, and who had taken a very leading and anxious pvjt in the business. In this representation it was frankly declared, that no promise more than of relief could be held out;^ but that, if the patient stil persisted in placing herself under my care, so far from shrinking from any effort, I would apply myself to the case with as much zeal and vigour as if an ultimate cure could be reasonably Contemplated. The following is Mrs. Jennings own statement of the origin and progress of the disease. <c ' In the year 1809, I first perceiyed a small lump in my breast, but thought little about it until the spring following, when it appeared somewhat enlarged, continued increasing in size, and became rather painful until June, when leeches were applied, which appeared to afford transient relief.
'In 1811, the lump having become larger, though with little pain, I consulted Mr. Cooper, who ordered a frequent application of leeches, which appeared to occasion a contraction of the parts affected. After some months the drawn parts (under the nipple) began to ooze, and a few large red pimples appeared near the iniddle.
" ' In 1812, I again shewed it to Mr. Cooper, when, upon Saying I should not like to undergo an operation, as the arms ap. peared to be affected : he answered, it is very fortunate when the patient and surgeon agree; and added, he thought, from the breast being jnuch lessened, it would probably quite disappear, when the complain^ Mr. S. Young on Cancer and Cancerous Tendency. 419 complaint might cease. He ordered leeches to be applied whenever the pain was troublesome, and gave me a prescription, which I followed until within the last half year. In the autumn of 1812, the red pimples broke, and have continued ia a state of ulceration ever since.
ii * About two years and a half since, the other breast became affected, and has gone on in the same way as the first, except that it has been attended with more pain. In the summer of J 814, I shewed it to another surgeon in Town, who said nothing conid be done; but added, when it was in great pain, I might put scraped carrot to the sores; and, upon my saying it never had been in much pain, he answered, perhaps not, but I must expect the pain to be extremely violent.
" ' It should be observed, that I had a very severe milk absccss of-the left breast with my first child, now thirty-two years since. The whole breast was greatly diseased and swelled. The eschars, that were left, were deep and Jarge. About nine years since, I had a violent blow on the same breast, from a butcher's boy in Leicester Fields. This, at the time, affected me so much, that I was obliged to go into a shop for relief. The pain, however, soon subsided, though at night it was again so painful as to induce me to-rub it with brandy. <? ' In this state I have remained, with this only consolation in my mind, that some fever might release me, or that the bleeding from my breast might carry me off, before the threatened and multiplied horrors of the complaint overtook me.' " Our limits only permit us to add the issue of this trulyinteresting case. " June 12, 1815.?The bulk (says Mr. Young) of the minutes prevents their further publication at the present period; but it may be satisfactory to add, that this extraordinary and interesting case has now arrived so nearly to a completion of cure, that in the course of a week, in all human probability, there will not be a point of sore which is not covered by perfect and,healthy cuticle. u Throughout the progress, the astonishing provisions of nature have been established beyond all former record; and now, over the original sore of the chest, as well as that of the left breast, a large sheet of complete skin is spread, which has been formed and forming for the last three months. Mr. Short, one of the surgeons to the Bedford Infirmary, has had the satisfaction of witnessing the progress of this extraordinary cure, the details of which is circumstantially continued in the minutes of the case yet to be pub- Critical Analysis. Such is the present state of this important change, we hope we may add, this important improvement, in the treatment of a disease the very mention of which has implied an incurable and painful local disease. We should add, that Mr. Whitbread's address has been properly attended to by the medical officers of the Middlesex Hospital. Indeed, from the invariable practice of that house, there can be no doubt that Mr, W.'s address, however well intended, was unnecessary; but it is with great satisfaction we can add, that the present trials encourage the further continuance of them. The title sufficiently explains the nature and subject of this little work. It only remains for us to observe, that the volume is likely to prove very beneficial to the public, and especially acceptable to all persons interested about horses.
The author has had much experience in the veterinary art, but has chiefly devoted his attention to draught horses, an abused and suffering class of animals. Though his remarks are the result of extensive observation, which his large practice has enabled him to make, he has trot omitted to consult other writers, and to select from them whatever is useful.
His knowledge of anatomy, both human and comparative, and his acquaintance with the true principles of science, fender his work more valuable than any that we have met with. " No man (he observes) can exercise this branch with credit to himself, or utility to the public, without a proper knowledge of anatomy. The veterinary surgeon labours under a disadvantage which does not apply to the human subject?his patient can give no information : he can only judge from appearances, and, unless he understand well the structure of the animal, the functions of every part, and the general harmony of the system in the sympathy of one part with another, he will often be at a loss to detect the presence and nature of disease; nay, not only must he trust to appearance, but he must often second this by examination, which can be of no avail without kaowing minutely the v structure 421 structure and disposition of each part."?As the treatise is not strictly within our department, we shall not enter further into its consideration, but conclude with recommending' it as a good practical performance.
Edinburgh Medical and Surgical Journal, No. XLIV. for October, 1815. Art. I,?Cases of Aneurism. By John Mackesy, Surgeon 1st Batt. 62d Regt. Case 1st was a Sicilian, aged 38, with a very large aoeurism of the femoral artery.
c< About a year from the period of my seeing him, while in thg act of lifting a heavy forge.bellows, he suddenly felt a violent pain, and sense of tearing, on the inside of the right thigh, at the part where the artery perforates the tendon of the triceps: he immediately lost the power of supporting himself, and fell on the floor in great agony. On recovering from the first sensation, he examined the pained part, and discovered, that a pulsating tumour, opened, and slit up for some space, the artery was without difS-# culty separated sufficiently from its attachments, with the handle of the scalpel; and, by means of the common eye-probe, a double ligature being introduced under it, one of them was tied two inches below Poupart's ligament, and the under one a little lower down, leaving a space of half an inch between them. The artery was now divided between the ligatures, and allowed to retreat within its surrounding cellular substance. " The wound appeared now of a great depth, owing to the tu* mefaction of the part; and the course of the artery was somewhat removed from its natural direction, being forced more inward, by the vicinity of the tumour. In prosecuting the dissection, the utmost caution became necessary not to open the fascia at the lower point of the wound, as here it appeared to form the immediate covering of the superior part of the aneurismal tumour. The wound being cleared of blood, the integuments were accurately brought together, and secured by sutures and adhesive straps. " The poor man bore the operation admirably, and his joy, on being informed that it was over, became so great, as to render it necessary to moderate it, by assuring him he was still in the ufc. most danger. The wound being dressed, the tumour was noty examined ; all pulsation had ceased; in other respects, the same as before. The patient, being laid in a bed made in the operating.
room, was led to repose. " 9th October, morning visit.?Rested tolerably well during the ?ight; pulse very little accelerated, and his skin Of a natural temperature; the surface of the tumour was warmer than usual, and tfie foot and leg of the same temperature as the sound one. LoW diet, and no medicines." In the progress of the cure, the patient was seized with hectic symptoms, which gave an unfavourable appearance to the incised wound, and produced slough and suppuration in the aneurismal tumour. Notwithstanding all which, he re* covered so far in the course of about ten weeks, as to be removed, in a state of convalescence, to the City Hospital.
The 2d patient was also a Sicilian, a native of Catania, subject to urinary calculi and other affections of the bladder and urethra. <c In the month of October, 1812, while endeavouring to raise a heavy copper boiler, he felt something tear, or give way, in the right groin, attended with extreme pain. On examining the pained part, he perceived a small pulsating tumour had formed, about the sige of an almond, which gradually increased in size; its advance, he conceives, has been considerably forwarded by his straining to make water. " I saw him, on the 15th of October, 1813, in a ward of the chief hospital of. Palermo, and the following appearances were* observable A large oblong, pulsating tumour occupied the right 4 . groin Edinburgh Medical and Surgical Journal, 423 groin inside of the thigh; its base extended from the spinous process of the ilium to within six inches of the knee; its apex ra, ther on the front of the thigh; and, about four inches below Poupart's ligament, a turgid branch of a vein run along its surface, ?which was painful, and covered vrith an erysipelatous blush of inflammation. The pulsation of the tumour was so strong, as ta render the raising and falling of the bed-clothes perceptible at each stroke of the artery; the foot and leg of the affected limb were cedematous, but of a natural temperature; the pulsation was most distinctly felt immediately under the femoral ligament, and at this point each pulsation gave to the finger a sort of jarring sensation; a low irritable fever was present, with quick wire-like pulse, 126 in the minute; great emaciation had evidently occurred, which, with a sunk eye, and general cadaverous aspect, forcibly declare# his miserable situation.
*' His medical attendants, viewing him, as it were, already in the grave, ceased their unavailing attendance. Extreme unction has been four times administered to him; and he has daily at his bed* side a priest, preparing him for another world. " The case was clearly an aneurism of the femoral artery, the vessel being ruptured where it passes over the brim of the pelvis, and under the ligament of Poupart. The complaint was of twelve months' duration, and was deemed by the attending medical officers of the establishment as incurable; the patient was, of course, left to a certain fate.
(i I proposed to one of the principal physician0 of the hospital (Dr. Calcagni), that there still existed a possibility of saving the patient by an operation, although, from his advanced age and un* favourable situations, the result would be very doubtful. This gentleman, in concurrence with the sub-director of the hospital, most readily agreed to an expedient which even held out remote hopes of success. The patient himself most anxiously begged that the operation might be performed immediately.
-don, the progress of the art is very slow in Italy, either from the little encouragement it receives, or From the paucity of establishments, and" the expence attending a migration to, and a short residence at, Pavia. On the operations, we shall only remark, that, as nothing could be more successful, so we conceive nothing could be more judicious. Respecting the cases, we feel obliged to the author for all the previous history he could collect, but hope, after the endeavours of Scarpa, and the addition which the industry and genius of Mr. Hodgson have made to this part of surgery, that the origin of such complaints will be by degrees better understood. Though the patients were first sensible of the pain, tumour, and pulsation, after violent muscular exertion, yet we are far from imputing the origin of the disease to that cause.
Probably the artery had been diseased long before, and only then gave way in its internal coat. These subjects must, we conceive, be soon better understood.
Art. II.?Case of Amaurosis cured by Active Treatment.

By John Bishop Estlin, Member of the Royal Medical
Society, Edinburgh, and of the Royal College of Surgeons, London.
Our readers will recollect the success ascribed by Mr. Stevenson to depletion in some cases of morbid sensibility of the eye, which have too often been considered as nervous, and treated in a very different manner. Mr. Estlin's case is very pointed and \^ery interesting, and might, without any disadvantage, have been given more at length. The patient, a female, only eight years of age, had previous symptoms of plethora or congestion about the head. On rising in the morning, her eyes had been so much affected during the night, that she was insensible to the light of the day. The mode of treatment was judicious as to the evacuations, but we suspect the author would have found more advantage from topical bleeding than the application of a blister to the head. This can only be meant as a hint, which Ave are not afraid will be well received by one who writes with such candour. " On inquiring (says Mr. Estlin) of the parents of the child respecting the prevailing disorders in their family, I found that they had lost^re children by some disease of the head, of which (he most striking symptom to their observation-was convulsions. The mother recollected, when I particularly asked her, that the subject of these remarks had for some time complained of head-ach, though it was not sufficient to prevent her from attending regularly the Lancastrian girls' school in this city, of which she was a pupil. Her boTfels were, in general, rather constipated. These circum.. attacked, and whether such as survived that period continued to be healthy, or free from those particular complaints. These inquiries may be highly important to any future offspring of the same parents. Art. III.?Case of Hydrophobia, unsuccessfully treated by copious Bleeding. By Dr. Albers, of Bremen. The case is very candidly related. The quantity of blood taken was considerable, and the first venesection only about six hours after the symptoms commenced. There was, however, a strong previous conviction in the mind of the patient that she must die, and, contrary to her own inclination, she ?was forced into the Infirmary. ( In the course of the day she had lost 80 02. of blood. We shall transcribe the concluding scene with only a single remark. u In spite of her excruciating thirst, she could not swallow a single drop; and the word drink alone was now sufficient to produce much more violent convulsive tremors in all her frame. The piUs and some bread she swallowed without any difficulty. The pulse was quick, yet not so low as to make me think I durst not venture on a repeated bleeding. When twenty ounces of blood had been drawn from her right arm, she nearly fainted, but soon recovered, and was put to bed. Soon after 1 had withdrawn, at eleven o'clock, she experienced a still greater oppression and anxiety, started from the bed, ran to and fro in the room, and from time to time cried out so, that her cries were heard at the distance of several houses from her habitation. She repeatedly warned her attendant to keep at a distance, that she might not bite him. She said that she was an unfortunate creature, and did not wish to bring her misfortune upon others. I am still uncertain whether she, actually felt this propensity to bite or not, (though I have witnessed the same symptom with another patient at the great hospital at Vienna,) and rather suspect that she had formerly been told, that people bit by mad dogs had an inclination also to bite. The terrible thirst she suffered forced her, from time to time, to dip her finger in the water-gruel, and moisten her tongue, which, as the nurse asserted, did, however, not increase the paroxysms of her anxieties. She now, likewise, felt such an aversion from the swallowing of the pills, that they must be put in her hand, while &he laid on her back, and then, with her eyes shut, conveyed them to her mouth. Till two o'clock in the morning, the paroxysms of anxiety, from time to time, subsided. After-that time, however, they continued, without intermission, till four o'clock, when the patient 427 "patient of a sudden became calm, dropped down, and expired.
At three o'clock she had sent for me, with the request, as she waft no more able to bear her oppression and anxiety, to bleed her to death ; which, as well may be thought, was not complied with. Instead of this, I prescribed pills, each of which contained one grain of ipecacuanha, and one grain of opium. On their arrival, the patient was no more." As, during the latter period, there were still symptoms of great anxiety, considerable action, and, probably, strength, would it not have been admissable to have repeated the bleeding? The proposal of bleeding her to death, we do not consider as any apolpgy for so doing ; but the relief she had experienced at each venisection, and the certainty of death if the then symptoms continued, might, we conceive, have been a sufficient indication of the remediurti ancepts of Celsus.* Art. IV.?Brief Hints, relative to the Improvement of the Pathology and Treatment of those Chronic Diseases usually termed Nervous. By John Armstrong, M.D. Sunderland.
Lord Chesterfield cautions his son against local wit, which, he observes, may be vapid in any other spot. We would, caution certain writers against local " hints." " Every practitioner," says Dr. Armstrong, " must be aware how vaguely we use medical language with regard to the term Neuroses." In confirmation of this, we have only to urge, as we have often done, the injury which medicine has sustained in many other instances, by the too early attempts of nosologists. But this injury has been greatly increased by the just celebrity, in other respects, of the northern school ; and by the nosological table becoming the text book of academic lectures. The injury to practice was, however, short-Jived in the south, and has long since ceased to exist, we believe, every where ; so that Dr. Armstrong's hints need not, as he addresses them, be directed to every practitioner.
Art. V.?Letter on the Treatment of Tetanus, to Dr. Dickson, Physician to the Fleets from Mr. E. Grimstone, Surgeon to his Majesty's Ship the Tonnant. This is a very judicious paper. The author divides tetanus into three varieties?the acute; the chrOnic from loCal injury; and the chronic idiopathic, or arising without any local injury. All these, he remarks, are most common in warm climates. * For a more successful issue from blood-letting in hjdro-j>hobia? see our Intelligence.

I 2
We 428 Critical Analysis, We conceive our author might have ventured on making two species, and dividing the last into two varieties. Our reason for mentioning this arises from his own well-founded observation, that the acute is, for the most part, the only dangerous forrn. The difference cannot be too strongly insisted on, because, for want of it, so much confusion has arisen in the application of remedies. In our late remarks on Dr. Perry's valuable treatise on this subject, we gave that gentleman the credit of being the first among the moderns to repeat an observation overlooked since the time of Celsus, viz. that the acute form of the disease usually proves fatal on the third day.